# Ankle sprains: Understanding, treating, and preventing recurrence Ankle sprains account for 85% of ligament injuries to this joint.^1^ They are one of the most common injuries in sports and everyday life. The good news is that with proper care, most sprains heal completely. However, about 40% of people develop chronic instability if they don't treat their sprain properly. This guide explains how to recognize a sprain, when to seek medical attention, and how to optimize your recovery. As physical therapists specializing in traumatic injuries, we assist patients with their rehabilitation on a daily basis. For an overview of conditions affecting this area, see our [comprehensive guide to foot and ankle pain](https://www.physioactif.com/guide-complet/douleur-pied-cheville-guide-complet). ## What exactly is an ankle sprain? An ankle sprain occurs when you stretch or tear the ligaments that stabilize the joint. Ligaments are fibrous tissues that connect bones to each other. Lateral sprains, which affect the outer ligaments, account for 85% of cases. The ankle has three main external ligaments. The anterior talofibular ligament (ATFL) is the most commonly injured. It resists when your foot turns inward. The calcaneofibular ligament (CFL) and the posterior talofibular ligament (PTL) complete this stabilization system. Ligaments do not contract like muscles. They heal more slowly. Their role is to prevent excessive movement of the joint. Unlike Achilles tendon tears (https://www.physioactif.com/diagnostic-et-traitement/douleurs/dechirure-du-tendon-dachille), ankle sprains mainly affect ligament structures rather than tendons. ## How does an ankle sprain occur? A sprain occurs when your foot twists beyond its normal range of motion. The most common mechanism is inversion: your foot turns inward. This often happens when walking on uneven surfaces or landing awkwardly after a jump.^1^ Inversion causes 80 to 85% of ankle sprains. Eversion, when your foot turns outward, is less common. It injures the deltoid ligament on the inside of the ankle. Common circumstances for sprains include: - Walking on uneven ground - Landing awkwardly after a jump (especially during intense sports activities) - Changing direction quickly in a sport - Falling from a step or sidewalk Athletes who participate in sports involving repeated jumping, such as basketball or volleyball, are particularly at risk. These movements can also cause other injuries such as [patellar tendinopathy](https://www.physioactif.com/diagnostic-et-traitement/douleurs/tendinopathie-rotulienne) in the knee. An important point: a sprain always results from a clear traumatic event. If your pain developed gradually without an accident, you probably do not have a sprain. In this case, it could be Achilles tendinopathy (https://www.physioactif.com/diagnostic-et-traitement/douleurs/tendinite-ou-tendinopathie-du-tendon-dachille) or another chronic condition. ## What are the different grades of ankle sprains? Doctors classify sprains into three grades according to their severity. Grade I: mild stretching. Grade II: partial tear. Grade III: complete rupture of the ligament with joint instability. The initial pain does not always reflect the severity. Some grade III sprains are less painful because the tear also breaks nerve fibers. A professional must assess your injury to determine the grade. ## What symptoms indicate an ankle sprain? Typical symptoms include immediate pain after the injury, especially on the outside of the ankle. Swelling may appear quickly or within a few hours. You may also notice bruising, have difficulty walking, and feel instability. Immediate symptoms include: - Sharp pain at the moment of injury - Sometimes a "pop" or cracking sensation - Difficulty putting weight on the foot In the following hours, the following may appear: - Progressive swelling - Redness and heat (approximately 48 hours) - Bruising if the ligaments have bled A minor sprain may not cause visible swelling. The bruising may migrate to the foot due to gravity. If you feel pain under your foot, this could also indicate plantar fasciitis (https://www.physioactif.com/diagnostic-et-traitement/douleurs/fasciite-plantaire-et-epine-de-lenoir), especially if the pain is localized to the heel. ## How can you tell if it's a sprain or a fracture? Your physical therapist will distinguish between a sprain and a fracture through clinical examination and the Ottawa rules. They will assess whether you need an X-ray. Precise bone pain, complete inability to walk, and severe swelling suggest a possible fracture. You need an X-ray if you have: - Pain directly on the bone when touched - Inability to take four steps - Are over 55 years of age Go to the emergency room if you notice visible deformity, feel extreme pain, or lose mobility completely. ## When should you see a physiotherapist for an ankle sprain? See a physiotherapist as soon as possible after the sprain, ideally within the first few days. You can make an appointment on the same day without seeing a doctor first. The first few days are crucial for optimal healing. You do not need a medical referral in Quebec. Access is direct. If your physical therapist detects a complication, they will refer you to the appropriate professional. To learn more about the [role of physical therapy](https://www.physioactif.com/guide-complet/physiotherapie), consult our comprehensive guide. During your first consultation, your physical therapist will: - Assess the severity of the sprain (grade I, II, or III) - Rule out the risk of fracture - Develop a customized treatment plan Seeking early treatment helps you avoid common mistakes, such as too much rest or returning to activity too quickly. The first 48 to 72 hours are crucial. ## How does physical therapy treat an ankle sprain? Physical therapy optimizes the healing environment. Your physical therapist eliminates factors that slow down healing: improper activity levels, excessive fears, joint stiffness, and poor biomechanics. Your body heals naturally. Inflammation is a normal and necessary process. Several factors can slow down healing: - Worries or fears - Inappropriate activity levels - Joint or muscle stiffness Think of a plant. You don't make it grow faster by pulling on it. Instead, you give it enough water and sunlight. To better understand the mechanisms of pain and how to manage it, see our guide on [chronic pain](https://www.physioactif.com/guide-complet/comprendre-la-douleur-chronique). Your physical therapist will advise you on the use of crutches, a splint, or a bandage if necessary. Find out how [physical therapy treats foot and ankle pain](https://www.physioactif.com/guide-complet/physiotherapie-pied-cheville). ## What exercises help heal an ankle sprain? Proprioception and balance exercises are essential for complete healing. They train your brain to better control your ankle. Proprioceptive training reduces the risk of recurrence by 35 to 50%. Proprioception allows your brain to know where your ankle is in space. Exercises on unstable surfaces and with your eyes closed gradually increase the difficulty. If you have ever suffered a calf strain (https://www.physioactif.com/diagnostic-et-traitement/douleurs/claquage-du-mollet), these balance exercises will also help prevent recurrence. ## How can you prevent ankle sprains from recurring? Complete your rehabilitation and do regular proprioception exercises. Approximately 40% of people develop chronic instability after a poorly treated sprain.^1^ Chronic instability makes the ankle feel "loose." This condition can lead to repeated sprains and premature osteoarthritis, similar to the degenerative processes seen in [knee osteoarthritis](https://www.physioactif.com/diagnostic-et-traitement/douleurs/arthrose-du-genou-gonarthrose). Effective prevention strategies: - Complete your rehabilitation program - Continue proprioception exercises after healing - Strengthen the muscles around the ankle, including the calf muscles, which play a stabilizing role - Warm up properly before playing sports - Wear appropriate shoes with good support Taping or orthotics can help you return to sports. However, these aids are not a substitute for exercises. For athletes, a gradual return is essential, similar to the rehabilitation required after a knee sprain (https://www.physioactif.com/diagnostic-et-traitement/douleurs/entorse-au-genou-et-dechirure-du-ligament-croise-anterieur-lca). ## How long does it take for an ankle sprain to heal? Healing time varies from 2 to 12 weeks depending on the severity. A mild sprain (grade I) heals in 1 to 2 weeks. A moderate sprain (grade II) takes 3 to 6 weeks. A severe sprain (grade III) requires 6 to 12 weeks. Several factors influence the duration: - The severity of the injury (grade) - The quality of your rehabilitation - Your injury history Do not base your return to sports solely on the absence of pain. Functional tests assess your strength, balance, and confidence. If you see no improvement after 10 days, consult a physical therapist. Healing times are comparable to other ligament injuries, but generally shorter than a meniscus tear (https://www.physioactif.com/diagnostic-et-traitement/douleurs/dechirure-meniscale) or fracture (https://www.physioactif.com/diagnostic-et-traitement/douleurs/fracture-de-la-hanche). ## Conclusion An ankle sprain is a serious but treatable injury. With proper care and complete rehabilitation, you can regain ankle stability and prevent recurrence. Seek medical attention promptly, follow your exercise program, and don't stop too soon. Remember that 40% of people develop chronic instability without proper rehabilitation. If you have suffered an ankle sprain, [make an appointment with our team](https://www.physioactif.com/diagnostic-et-traitement/douleurs/pied) for a complete evaluation. For other foot and ankle conditions, see our guides on [Morton's neuroma](https://www.physioactif.com/diagnostic-et-traitement/douleurs/nevrome-de-morton), [hallux valgus](https://www.physioactif.com/diagnostic-et-traitement/douleurs/hallux-valgus), or [metatarsalgia](https://www.physioactif.com/diagnostic-et-traitement/douleurs/metatarsalgie). ## References 1. Vuurberg G, Hoorntje A, Wink LM, et al. Diagnosis, treatment, and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med. 2018;52(15):956. --- *Article written by the Physioactif team* *Last update: January 2026*